Thread by @chrischirp

THREAD on why "living with" frequent mass Covid infections is a BAD IDEA (& what we can do!):

There is a negative feedback cycle for transmission & *each time* we go through it in a wave we damage our people, our NHS and our economy a bit more.

let me show you how... 1/17

Waves often start in undervaccinated, highly mixing groups: children and/or young adults.

The first consequence (particularly in children) is educational disruption as children and teachers suffer 2/17

The second consequence is that infections don't stay confined to a single age groups, but spread to the rest of the population.

In Jan, from kids to parents to other age groups. In this current wave from young adults to other age groups.

So we get a big population wave. 3/17

Lots of people with Covid means lots of people off sick - either short term with acute Covid or longer term if they develop persistent severe symptoms.

Short term means economic disruption as lots of workplaces struggle to continue with staff absence. 4/17

Long term sickness rises with every wave and depletes our workforce - especially as Long Covid commonest in adults of working age.

Vaccination & prev infection have *not* solved the problem of Long Covid. Even Bank of England warning & business leaders warning about this! 5/17

And yes - deaths and ICU admissions from Covid have reduced massively since vax (good!) BUT overall hospital admissions with Covid remain high - and add burden to people who are sick (either with covid or something else) and the NHS 6/17

And these high numbers of admissions - with little relief in between waves since last summer - is adding more and more pressure to the NHS - both acute and chronic care.

The NHS is slowly - publicly - breaking. 7/17

High workplace absence & cost of living mean more people feel they have to work when sick. That plus barely any mitigations means more exposure & infection.

And loads of infections means more chances for the virus to mutate further, more chances to find fitter versions... 8/17

The virus evolves & drives more waves. Waves are closer together & higher in 2022 than in previous years!

Lots of evolutionary space left, & there is no inevitability towards mildness.

Next variants growing somewhere already. If not BA.2.75, will be something else. 9/17

The next wave in autumn is inevitable - the virus is evolving, vaccines are waning, Omicron infection does not provide great protection against new infections, and there are no mitigations in place to prevent transmission.

Literally what process will stop another wave?! 10/17

And so we are stuck in this cycle. And every wave drags down our education system, drags down our health system, drags a few more people out of the work force, disrupts a lot of people's lives.

How is this sustainable? 11/17

It's also made worse because there is a nested negative feedback cycle within this transmission cycle which is driving increasing inequality in our society.

So what can we do? 12/17

Well if we want to reduce impact of Covid we can reduce exposure (fewer infectious people mixing), reduce impact of exposure (lower chance of catching it if exposed) and/or reduce impact of getting covid (lower chance of needing hospital, dying getting Long Covid). 13/17

Vaccines are great because they impact all THREE things - but as they wane & Covid evolves, they become less effective at reducing exposure or impact of exposure.

Currently vax is our *only* mitigation though and that's not enough. 14/17

We need additional things.

In the beginning - esp because without vaccines or treatments - we reduced exposure through restrictions like lockdowns or limits on gatherings. This is not sustainable. BUT some things are ... and we know they work too!

15/17

We can reduce exposure by asking infectious people to stay home - with good sick pay & support.

We can reduce impact of exposure through clean indoor air, masks, PPE where needed & prioritising outdoor living where possible. 16/17

Reducing exposure & its impact is also v efficient as it happens *before* infection to reduce total cases each wave.

Developing next gen vax will also massively help to reduce exposure & impact!

So - how many waves will pass before *you* demand action from our leaders?

17/17

PS for clarity I am using "feedback cycle" to mean "reinforcing cycle" and "negative" to mean it's detrimental.

So not the scientific meaning where it's a dampening effect! i think calling it positive feedback would be confusing you see...